Narcissists, much to the surprise of many experts, are in the process of becoming an endangered species. Not that they face imminent extinction — it’s a fate much worse than that. They will still be around, but they will be ignored. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [due out in 2013, and known as DSM-5] has eliminated five of the 10 personality disorders that are listed in the current edition.
Narcissistic personality disorder is the most well-known of the five, and its absence has caused the most stir in professional circles… Most of us would agree that this is an easily recognizable profile, and it is a puzzle why the manual’s committee on personality disorders has decided to throw N.P.D. off the bus. Many experts in the field are not happy about it. Actually, they aren’t happy about the elimination of the other four disorders either, and they’re not shy about saying so. One of the sharpest critics of the DSM committee on personality disorders is a Harvard psychiatrist, Dr. John Gunderson, an old lion in the field of personality disorders and the person who led the personality disorders committee for the current manual…
“It’s draconian,” he said of the decision, “and the first of its kind, I think, that half of a group of disorders are eliminated by committee.” He also blamed a so-called dimensional approach, which is a method of diagnosing personality disorders that is new to the DSM. It consists of making an overall, general diagnosis of personality disorder for a given patient, and then selecting particular traits from a long list in order to best describe that specific patient…
They might as well say that making a diagnosis of personality types is on no use and eliminate the category altogether. Somehow, it feels like this proposed change is being directed by the whole "evidence based" medicine movement, a particular favorite among the group of Biological Psychiatrists that essentially don’t want to talk about anything that can’t be treated with some kind of drug – and since Personality Disorders aren’t in that category, don’t understand enough about personality formation to qualify to give an opinion.
I found your blog when trying to get some details about the recent NPR story. Your blog surpasses all the media coverage I can find! Thank you for such a smart, thoughtful and detailed report. You clearly have much to offer the world in retirement. Please keep it up.